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生姜，姜虫^[1] ，泽兰，白及，双白^[2] ，木香，砂仁，独活，羌活，干葛^[3] ，贝母，双寄生^[4] ，以米^[5] ，生芪^[6] ，黄芩，何叶^[7] ，五味子，炙党^[8] ，只壳^[9] ，防风，牛子^[10] ，金银花，京芥^[11] ，苏子，兜铃^[12] ，橘红，生甘炒^[13] ，射干，神曲，熟地黄，泽泻，射香^[14] ，三棱，莪术，款冬花，元胡

Sheng Jiang, Bai Jiang Can, Ze Lan, Bai Ji, Sang Bai Pi, Mu Xiang, Sha Ren, Du Huo, Qiang Huo, Ge Gen, Bei Mu, Sang Ji Sheng, Yi Mi, Sheng Huang Qi, Huang Qin, He Ye, Wu Wei Zi, Zhi Dang Shen, Zhi Ke, Fang Feng, Qian Niu Zi, Jin Yin Hua, Jing Jie, Su Zi, Ma Dou Ling, Ju Hong, Sheng Gan Cao, She Gan, Shen Qu, Shu Di Huang, Ze Xie, She Xiang, San Leng, E Zhu, Kuan Dong Hua, Yuan Hu

Ba Shi Fo Xi ( litter ) Mei (sister) recieved Zhao Fu ( shine fortune)

Yi Yi Nian ( year ) 4-21-1905

Translated by William Dong and Leo Zhu
The patient's name and date are edited by Li Chen

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1. ^ Another name of 白僵蚕 Bai Jiang Can
2. ^ Another name of 桑白皮 Sang Bai Pi
3. ^ Should be 葛根 Ge Gen
4. ^ Should be 桑寄生 Sang Ji Sheng
5. ^ Should be 薏米 Yi Mi
6. ^ Should be 生黄芪 Sheng Huang Qi
7. ^ Should be 荷叶 He Ye
8. ^ Should be 炙党参 Zhi Dang Shen
9. ^ Should be 枳壳 Zhi Ke
10. ^ Could be 牵牛子 Qian Niu Zi
11. ^ Should be 荆芥 Jing Jie
12. ^ Should be 马兜铃 Ma Dou Ling
13. ^ Should be 生甘草 Sheng Gan Cao
14. ^ Should be 麝香 She Xiang